Oral Cavity: an Inception to Diagnose Plasma Cell Myeloma. Case Report and Literature Review

Abstract

Plasma cell myeloma (PCM) is a malignant disease of monoclonal plasma cells which is multicentric in origin. The accurate diagnosis demands contemplation of conventional histopathology with meticulous correlation of medical history, clinical and imaging details; and adjunctive investigations. We report a case of 50 year old female who presented with chief complaint of diffuse swelling of jaw and close observation revealed walking difficulty attributed to bone pain. Imaging showed ill-defined punched out lesions in left mandible. Biopsy with adjuvant immunohistochemistry revealed features suggestive of plasmacytoma and work up for plasma cell myeloma was advised. Further investigations showed features of end organ damage (hypercalcemia, increase serum creatinine, anemia, and > 1 osteolytic lesions). Serum electrophoresis and bone marrow aspiration confirmed the diagnosis of plasma cell myeloma. Patient was referred to oncology department where thalidomide was prescribed and patient showed drastic improvement in symptoms within a month. However demise of patient occurred after 7 months which might be attributed to delay in diagnosis by the clinician. Thus, this case report highlights the need of awareness and knowledge on the part of dental professionals for even rare systemic diseases to emphasize early diagnosis and treatment.